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Med Oral Patol Oral Cir Bucal. 2009 Nov 1;14 (11):e573-8.

Oral health related quality of life

Journal section: Oral Medicine and Pathology Publication Types: Research

doi:10.4317/medoral.14.e573

Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population Fatma Caglayan 1, Oguzhan Altun 1, Ozkan Miloglu 1, Muhammed-Dursun Kaya 2, Ahmet-Berhan Yilmaz 3

Researcher, Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum/Turkey Assistant Professor, Department of Vocational Collage at Erzurum, Ataturk University, Erzurum/Turkey 3 Professor, Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum/Turkey 1 2

Correspondence: Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, 25240 Erzurum / TURKEY [email protected]

Caglayan F, Altun O, Miloglu O, Kaya MD, Yilmaz AB. Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population. Med Oral Patol Oral Cir Bucal. 2009 Nov 1;14 (11):e573-8. http://www.medicinaoral.com/medoralfree01/v14i11/medoralv14i11p573.pdf

Received: 04/11/2008 Accepted: 10/03/2009

Article Number: 2532 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: [email protected] Indexed in: -SCI EXPANDED -JOURNAL CITATION REPORTS -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español

Abstract

Objectives: The purpose of the present study is to determine the nature of the complaints that bring patients to our clinic and to what degree these complaints affect their quality of life (QoL). We also aimed to determine any associations between gender, education or harmful habits and each patient’s oral health-related quality of life (OHQoL). Methods: A total of 1090 patients, consisting of 651 females (59.7 %) and 439 males (40.3 %), were included in this study. Of these patients, 220 constituted healthy controls. Two patient-centered outcome measures, the 14 item OHIP-14 and the 16 item OHQoL-UK measures were used. Results: Most of the patients presented with toothache and caries (50.1 %), 11.2 % had suffered tooth loss and had denture needs, 9.2 % had periodontal problems, 1.8 % had temporomandibular joint (TMJ) disorders, 3.8 % had buried third molars, 2.4 % had orthodontic and aesthetic disorders, 1.3 % had suffered injury due to trauma, and 20.2 % came only for control checkups. OHQoL was best in the control group and the worst in patients who had suffered trauma. In addition, we noted correlations between gender, education and harmful habits, and that of the patient’s oral health-related quality of life. Conclusion: According to our results, OHQoL is associated with the oral complaints of patients. Furthermore, OHQoL may not only be associated with the oral health status of patients, but factors such as gender, education and harmful habits may also play a role. Key words: Oral health, quality of life.

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Introduction

association between gender, education, harmful habits and their oral health QoL.

Patient-centered approaches have been receiving increasingly more attention in recent years. It is important to determine the nature of the complaints that cause patients to seek treatment and to what degree these affect patients’ quality of life (QoL). There is an increasing recognition that oral health has a significant impact on not only physical, but also social and psychological well-being. As in general medicine, perceptions of dental patients are also important in the assessment of treatment need, in planning of appropriate therapy and in clinical outcome. The patient-centered outcome measures may therefore also be utilized in oral medicine. While the majority of oral diseases are not fatal, they can give rise to significant morbidity, resulting in physical, social and psychological consequences which affect patients’ QoL (1). Interest in the idea of quality of life is growing rapidly. More than 1000 new articles are indexed each year under this heading (2). QoL is affected by oral health in some way in the majority of people (3). A variety of patient-centered outcome measures termed ‘oral health related quality of life measures’ (OHQoL) have been developed to assess the extent to which oral health problems affect not only physical functioning and pain, but broader constructs such as psycho-social functioning and life satisfaction (1). A number of OHQoL measures have been developed and are presently being evaluated. Eleven OHQoL measures were reviewed at an international meeting held at the University of North Carolina in 1996 (4). It was mentioned that two measures which had received particular attention were the Oral Health Impact Profile (OHIP-14) and the UK Oral Health Related Quality of Life (OHQoL-UK©) questionnaires (5,6). These measures are based on two conceptually distinct models of oral health. The OHIP-14 consists of self-reported measurements of the adverse impacts of oral conditions on daily life. Originally developed in Australia, it is based on a conceptual model of oral health that uses the World Health Organization (WHO) International Classification of Impairments, Disabilities and Handicaps framework (7). The original 49-item questionnaire has been shortened to 14 items by Slade and has allowed use of a validated index of the impact of oral health (5). Since its development, the OHIP-14 is preferred to the OHIP-49 by a number of researchers due to its practicality. OHQoL-UK, recently developed in the United Kingdom, is based on the WHO model of “structure-function-ability-participation”, which incorporates both negative and positive influences on health (8). The purpose of the present study is to determine which complaints cause patients to come to our clinic and to what degree these complaints affect their QoL. Furthermore, we aimed to determine if there was a possible

Materials and Methods

Study population This clinical-based descriptive study was carried out in the Oral Diagnosis and Radiology Department of the Faculty of Dentistry, Ataturk University. Consecutive 1090 patients were included the study. 220 of these constituted healthy controls. Patients less than 18 years old and patients who could not give adequate data were not included the study. The examination of patients and application of questionnaires were carried out by three researchers. Firstly, each patient’s name, surname, age, gender, place of birth and educational status were recorded, and a medical history was taken. Any systemic disease or drug use was noted. Clinical and radiographic examinations were performed. After intra-oral examination, dental outpatients were asked to complete patient-centered outcome measures. For standardization of the study, the first researcher trained the other two researchers in the clinical assessment and implementation of the questionnaires. All researchers agreed upon which questionnaires would be included or excluded in the study. The questionnaires were implemented in a face to face interview. Data Collection Two patient-centered outcome measures, the 14 item OHIP-14 and the 16 item OHQoL measure (OHQoLUK) were used in this study. The questionnaires were translated into Turkish, in accordance with cross-cultural adaptation guidelines, to produce a Turkish version of the OHIP-14 and the OHQoL (9,10). Both measures had been previously validated with Turkish dental outpatients (9). Data Analysis Scores were derived from both questionnaires by summing the responses to each of the individual questions within the measures. The questions for OHIP-14 were asked as “………………..because of your teeth, mouth or denture?” For the OHIP-14, each item was scored: ‘never’- score 0, ‘hardly ever’- score 1, ‘occasionally’- score 2, ‘fairly often’- score 3, ‘very often’- score 4. Higher scores indicate poorer oral health-related quality of life. The questions for OHQoL-UK were asked as “What effect does your oral health have on your………………” For the OHQoL-UK, the response categories were ‘very bad effect’-score 1, ‘bad effect’score 2, ‘no effect’- score 3, ‘good effect’- score 4, ‘very good effect’- score 5. Lower scores indicate poorer oral health-related quality of life. Thus, better OHQoL was indicated with lower scores in OHIP-14, and with higher scores in OHQoL-UK questionnaires. The collected data were analyzed by SPSS 10.0 softe574



large part of it. Most of the patients generally came to the clinic with the complaint of caries and toothache (50.1%), 11.2 % tooth loss and denture need, 9.2 % periodontal complaints, 1.8 % TMJ complaints, 3.8 % buried third molars, 2.4 % orthodontic and aesthetic defects, 1.3 % trauma, and 20.2 % for only control. While 77.6 % of the patients have no harmful habits, 20.9 % of them were smokers, 0.6% was drinking alcohol and 0.9% was both smokers and drinking alcohol. The median scores of patients’ answers to OHIP-14 and OHQoL-UK questionnaires are shown in Figure 1 and Figure 2. The main difference between OHQoL-UK

ware program. The Mann-Whitney test was used to compare the OHQoL of females and males. KruskalWallis test was used to identify differences in OHQoL with patients’ complaints, education, and harmful habits. The OHIP-14 and OHQoL-UK scores of groups are expressed as median (interquartile range). p0.05). The median OHQoL-UK score of females was 2.87 (0.81) and males 2.87 (1.00). However, OHIP14 scores of females were higher than those of males

0.001**

0.71 (0.93)

0.000**

0.93 (1.00)

(p